Individual
MRS. LYNNLEE FULLENWIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR L CHT
Contact information
Practice address
12911-120TH AVE. NE,, SUITE F-120, KIRKLAND, WA 98034-3025
(425) 823-1389
(425) 820-3996
Mailing address
12911-120TH AVE. NE,, SUITE F-120, KIRKLAND, WA 98034-3025
(425) 823-1389
(425) 820-3996
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT00000365
WA
225XH1200X
Hand Occupational Therapist
9105000003
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0282300
L & I
WA
01
—
0282315
L & I
WA
01
—
0282323
L & I
—
01
—
34464
L & I
WA
05
—
7680697
—
WA
01
—
FU4123
REGENCE
WA
Enumeration date
03/07/2007
Last updated
02/29/2012
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